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Online consultations & the 50+ group: Why hasn’t it happened already?

Sofia Pyrgioti

<span id="hs_cos_wrapper_name" class="hs_cos_wrapper hs_cos_wrapper_meta_field hs_cos_wrapper_type_text" style="" data-hs-cos-general-type="meta_field" data-hs-cos-type="text" >Online consultations & the 50+ group: Why hasn’t it happened already?</span>

The most dominant narrative in digital health lately has naturally been how the pandemic has accelerated digital transformation in healthcare. While this is an undeniable fact – and one to be proud of – how have the patients perceived digital health? Are healthcare and patients at the same pace – or even on the same path?

In a previous interview with Michael Oliver, project manager at Livewell Southwest, the Integrated Care provider who wrote their own digital health success story, Michael highlights the importance of bringing the patients on board:

We need to bring the public with us because we’ve been racing for the last nine months. COVID has been really beneficial in pushing digital transformation forward, but people in the UK want to get back to normal and that often means seeing people face-to-face. So it is important to not leave patients behind on this journey, and encourage people to see that this is a good mechanism.

The only question that remained was: Are patients on board with digital transformation in healthcare – on a national level? The answer was, unfortunately, not quite. During the last quarter of 2020, Visiba issued an investigation around the perceptions and behaviours regarding digital healthcare in light of the COVID-19 pandemic. 1,050 people demographically and regionally representative of England were surveyed and the results were illuminating. People over 50 were not reached by this wave of digital transformation: 2/3 did not have an online consultation at all.

Over 50s are not accessing online consultations

What makes this group so critical?

Patients over 50 have the highest attendance in outpatient appointments. This is a group that is very much active and productive in their communities. In addition, health management of this population group is critical for the overall picture of national health picture and the implications on the NHS for the near future. For these reasons, over 50s are one of the most fruitful groups to reach out to with digital health, as they have increased needs in their contact with healthcare as well as a high prospect of improving their overall health and optimally manage any pre-existing conditions.

NHS outpatient attendances by age group

In a positive addition, this is not a digitally excluded group: 83% of people aged 55-64 use the internet, and the same percentage for 55+ overall is 68% [1]. Specifically for healthcare, looking across the range of offered digital services, people aged 55-74 were most likely to have used them – with ordering repeat prescriptions being the most commonly used service. Finally, the advantages of online consultations are evident in this group, assuring the presence of a strong motive: only 11% of the respondents see absolutely no advantages to online consultations.

What prevents over 50s from accessing online consultations?

The first step to solving a problem is understanding it. So, we investigated why this group has not accessed online consultations.

The first reason seems to be an element of social responsibility. People over 50 were the most eager to adhere to the lockdown rules. At the same time, our survey results show that survey respondents aged 50-64-years-old were those that had accessed healthcare the least. The element of social responsibility has most likely been decisive: The concern to ‘protect the NHS’ is quite strong in this population group

Another reason appears to be intimidation. The minority who are not internet users feel that ‘it is not for people like them’ and that it is too complicated. It’s important to keep in mind that these people have these feelings without accessing the internet – our results showed that this is a highly and easily reversible attitude: In comparing the results among those who have had an online consultation and those who have not, over two thirds (68%) of those who attended an online consultation said they feel as safe and comfortable with having one online as a physical one, compared with only 41% of those who hadn’t.

The final potential hindrance we identified was trust: Adults over 45 tend to be less confident about managing access to their personal data online. Taking into account that the NHS is the most cherished institution and the most relevant and trusted brand in the UK [2][3], there is great potential for this apprehension to be counterbalanced.

What can the NHS do to reach this group?

The results for the over 50 age group from our report became even more interesting exactly because of the potential of this case: Naturally, this is an age group that requires extra attention and resources from the NHS, but also the attitudes of this group provide a fruitful ground to remove what they perceive as hindrances to accessing online consultations. In other words, in this very important game, the board is set!

Report Digital transformation for everyone Read our report on the attitudes of English patients towards online consultations based on a survey of over 1,000 patients in 2020. To the report
Since the population is so invested in the wellbeing and prosperity of the NHS, the strategic rationale for making online consultations available should be thoroughly communicated. Patients should know, as much as NHS professionals, that online consultations free clinical time for appointments that need to be done face-to-face – typically for those with patients with more complex cases. However, if those who are sickest are best served by face-to-face appointments, there is still a population of adults who would benefit from online consultations and reaching them would free valuable clinical time for other urgent face-to-face appointments.

To overcome their intimidation, patients need to be provided with the most user-friendly and straightforward tools to access online consultations. Good design is vital to enable people to access online resources, and best practice ensures that designs are tested on users of all abilities and refined based on their feedback. Considering the increasing uptake of mobile usage in the 50+ age group, a mobile-first option should be widely available. Inclusive accessibility from all aspects and usability should be top-priority and assured with patient satisfaction evidence for any platform that provides online consultations now and in the future.

When it comes to trust, the ways to strengthen it are evident. With the overwhelming vote of confidence in the NHS brand and institution, the most fruitful way of increasing trust in online consultations is to make it clear that this is an NHS service. The picture so far is that most online consultations are happening via a prominent third-party provider that the patients are either unaware of or know that is not healthcare-specific. Our survey respondents confirmed: 63% said they felt more comfortable with consultations provided directly through their regular healthcare provider. This highlights the need for the NHS to provide digital care that visibly comes from the patients’ regular providers.

Obstacles in the NHS are often complex, multi-layered and time-consuming; Accessibility to online consultations for the imperative 50+ group is not one of them – and the data confirms it. Moreover, the NHS itself is on an already accelerated pace and a lot of the groundwork has been covered during the hectic pandemic months. Engaging online with the population over 50 is a decision’s reach away.